Implants, Crowns, and Bridges vs. Natural Teeth

Nothing can replace the natural teeth you were born with for chewing and function. However, very few people go through life without having teeth filled, crowns (caps) placed, or bridges and implants used to replace missing teeth. Crowns, bridges, and implants are the best answer and closest to your natural teeth, but they are not the same as healthy, natural teeth.

Crowns

Crowns are used to reconstruct a single tooth broken down by dental decay. Crowns are made of ceramic, resin, porcelain, porcelain plus metal, or resin plus metal materials. They are bonded or cemented onto the prepared tooth and cannot easily be removed from the tooth once placed. If the tooth was in good alignment before the crown was prepared, the crown will be in good alignment. If the tooth was misaligned before the crown, sometimes the crown may be made to obtain a more ideal shape and position. It is cleaned and flossed just like a natural tooth and is most like real teeth.

Bridges

Bridges are crowns that are attached together, suspending the crown portion of a false tooth in or over the space left by the missing tooth. A bridge can be used to replace one or several teeth. Sometimes a bridge is used to splint loose teeth together in order to make the teeth more stable. Bridges are usually made of metal covered with either porcelain or resin. Some of the newer bridges are made of all resin or all ceramic materials. They are cemented or bonded onto the existing prepared teeth and are not easily removed once placed. The bridge teeth can be brushed the same as natural teeth, but since they are attached together, must be flossed differently by using a floss threader or other device.

The teeth are generally the same shape as natural teeth. However, if the existing teeth (abutments) that are used to anchor the bridge have moved from their original position because a tooth or teeth have been missing for years, the added tooth (pontic) may be longer or shorter than the tooth that it is replacing. With a bridge, the false tooth will most often butt up against the soft tissue ridge where the removed tooth was.

The shape of the tongue side of the false tooth varies. It is usually smaller on the tongue side and completely fills the space. Food will have more of a tendency to collect in this area, so you must be prepared to clean it. If the missing tooth has been gone a long time, the ridge may have shrunk considerably, and the pontic tooth will be longer that the teeth on either side. If this is the case, there are several periodontal procedures that can be done prior to the construction of the bridge. These procedures will build up the tissue to its former height. The more your mouth has changed from its normal state, the harder it is to make new teeth look and feel natural.

Implant Crowns

Implant crowns are used to replace single or multiple missing teeth. They are either cemented or screwed-retained onto an implant fixture. The crowns are made of porcelain or resin and metal. But they have some significant differences from the natural teeth they replace. Teeth are supported by a root or roots that are irregular in shape. Implants are round. The cross-sectional of the implant will never match that of the tooth it is replacing. A multirooted tooth may be replaced by a single implant, so the manner in which an implant crown comes out of the soft tissue ridge will appear different from a natural tooth. There will be more space between the implant root and the adjacent teeth. Implant crowns are often cemented with temporary cement. This allows the dentist to easily take off the crown and evaluate how the implant is doing. Crowns on teeth are usually cemented with a final cement. Implant-supported crowns are wonderful, but not the same as natural teeth with crowns. Be prepared for some differences. Expect more maintenance on your part and in the dental office with crowns, bridges, and implants.

Smokers take note: There is a heightened risk of dental implant failures among smokers—as much as 20% greater failure rate!

6 Of The Most Common Dental Problems, Fixed!

Smile! There’s good news from the world of dentistry: Older American are keeping their teeth longer than ever before and the average number of teeth people retain into old age is increasing, says Judith Ann Jones, DDS, a spokesman on elder care for the American Dental Association and director of The Center for Clinical Research at the Boston University Goldman School of Dental Medicine.
But Jones is not all smiles. As people keep their teeth longer, there are more problems that are likely to arise, which is why keeping up with regular dental visits is so important. Here are the most common problems, and what you can do about them:

Tooth Decay

Yes, people over 50 can get cavities. You can get them on the surfaces of teeth that have never been a problem before, but you can also get them around old fillings or at the root of your tooth. “As you age, the root of your tooth becomes softer and sometimes more exposed,” Jones explains.
The Fix: Fluoride is not just for kids, Jones says. “Fluoride is one of the 10 most important health measures developed in the 20th century.” Almost 80 percent of people in the United States have fluorinated water, but if you don’t, you should probably add a daily fluoride rinse to your brushing habit. Or ask your doctor about a stronger fluoride prescription gel. If you are starting to get cavities, even if your water has fluoride, consider a fluoride rinse. Ask your dentist if that’s right for you.

Dry Mouth

Saliva protects us against tooth decay. But if you’re not producing it, your teeth may be at risk. The calcium and phosphate present in saliva prevent demineralization of your teeth, Jones says. How do you know if you have dry mouth? You’ll have a sticky feeling in your mouth, trouble swallowing, dry throat, and dry, cracked lips. You may notice a metallic taste in your mouth or persistent bad breath. You may or may not feel thirsty. Dry mouth is often caused by medications, and as people age, they take more medications. It can also result from smoking or from a blow to the head that somehow damages the salivary glands.
The Fix: If you have dry mouth, you should try to stimulate saliva production. Jones says some people just sip water all day while others find that chewing sugar-free xylitol candies or gum helps. Your dentist may prescribe a prescription saliva substitute or recommend over-the-counter formulations for you to try.

Gum Disease

If your gums are swollen, red, or bleed easily, you’ve got gingivitis, an early form of gum disease that can progress and be dangerous. Untreated gingivitis often becomes periodontitis, which is when the gum pulls away from the tooth and creates pockets which can become infected. If this condition develops and continues unchecked, it could cause the loss of bones in your jaw and eventually, the loss of the teeth themselves.
The Fix: The best fix for this condition is regular dentist visits, Jones says. You may need to visit your dentist more frequently so that your teeth can be cleaned and your gums treated for the condition. People who don’t have good access to dental care are more likely to have gum disease, Jones says.

Oral Cancer

More than 43,000 Americans will be diagnosed with oral cancers this year, and more than 8,000 will die from it, according to The Oral Cancer Foundation. Oral cancer incidence definitely increases as you get older, Jones says, and is very often linked to smoking and heavy alcohol use. Recently, the number of cases has risen because doctors have discovered that the Human Papilloma Virus also can cause oral cancer.
The Fix: Only about half of people who develop oral cancer survive the disease, Jones says. The best hope for survival is to discover it at its earliest stages—in which case there is an 80 percent chance of surviving for five years. Your dental exam should include a check for oral cancer. Your dentist will hold your tongue and check the soft tissue in your mouth as well as your throat and jaw. If he or she does not, find another dentist, Jones says.

Tooth Crowding

Are you noticing that food is getting stuck in new places in your mouth? Or that the overlapping tooth that was cute in your teens now seems to be overlapping even more? You’re not imagining it. As you age, your teeth shift, according to Lee W. Graber, D.D.S., M.S., M.S., Ph.D., Past President of the American Association of Orthodontists. And that can be problematic, not because you’ll look different, but because it can make your teeth more difficult to clean, leading to more decay. It’s also of concern because misaligned teeth can lead to teeth erosion and damage to the supporting tissue and bone, Graber says. Add to that the tendency of older adults to have periodontal disease, and you could end up losing your teeth even faster.
The Fix: If your teeth have really shifted, you could see an orthodontist, who may fit you with a retainer, spacer, or even braces. This may not be necessary, but you should discuss with your dentist whether your teeth are shifting at your regular check up. If they are, it may mean only that you need to go to the dentist more regularly for more frequent cleanings.

Grinding and Clenching

This is not a habit that begins late in life, but it’s one whose effects might be most pronounced as you age. If you tend to grind your teeth or to clench them in your sleep, you may grind through the enamel to the dentin, which can cause pain and decay. Also, if you have crowns or bridges in your mouth, they may be damaged by such habits.
The Fix: Your dentist can give you a night guard, a small mouth piece that will protect your teeth while you sleep—and protect your investment in the dentistry that’s already there, Jones says.

By: Andrea  Atkins, The Huffington Post
http://www.huffingtonpost.com/entry/6-of-the-most-common-dental-problems-fixed_us_58346501e4b099512f84b510

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

Crowns: An Overview

Why would I need a crown (cap)?
1. A tooth has been so badly damaged by decay or so heavily restored by fillings that it can only be saved with cast restoration
2. A tooth has been treated endodontically (root canal treatment). These teeth are almost always restored with a cast restoration because they have lost a great deal of tooth structure from fracture, decay, or the drilling process. These teeth are prone to fracture under normal and light chewing forces.
3. The tooth needs to be used as an abutment (anchor) for a bridge to replace missing teeth.
4. Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. 

What are dental crowns?
Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability. Click here to learn about the difference between crowns, bridges, and implants.

What kinds of crowns are there?
Expect to pay more for porcelain crowns because they are usually more time-consuming than gold crowns. Porcelain, porcelain over metal and gold crowns average between $600 to $3100 each in total cost. The new reinforced resin or bonded all-porcelain type costs more than other types, require more skill from your dentist and the lab, and may exceed your insurance plan coverage for crowns.

• Resin and Porcelain Crowns

• The new reinforced resin or bonded all-porcelain type of crown as the nicest appearance. This crown can be made from pure ceramic or a new reinforced composite resin, and is almost indistinguishable from natural teeth. Thew new bonding technology involved provides an exceptional bond to your tooth. It is metal-free, and thus satisfies the needs of patients with metal sensitivities. When correcting your back teeth with bonding, the cosmetic dentist will perform a tooth colored onlay. This type of procedure is used to correct only those parts of the tooth that are in need. This is a metal-free procedure. 
• Advantage: Porcelain crowns or new reinforced resin are considered to be the most aesthetically pleasing, as it is so easily matched in color to the surrounding teeth
• Disadvantage: The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure needs to be removed. It is more difficult for your cosmetic dentist to get an ideal fit where your gum meets the crown. Gingival inflammation appears to be more common with porcelain crowns that gold crowns. All-porcelain crowns require a higher skill level from your dentist and lab.
• Crowns Made of Gold

• Gold crowns are appropriate when appearance is not a priority to you. The gold metal is extremely workable, making gold crowns a more precise fit than any other type. While there exists a slight possibility of chipping with porcelain crowns, gold crowns provide no such possibility.
• Advantage: The preparation of a tooth for a gold crown is the simplest and least complicated preparation as there is minimal tooth structure removal with as much as possible of the healthy tooth structure remaining untouched. While porcelain is hard by comparison, it may cause wear on opposing teeth over the years where goal is not as likely to do so. Gold is also easier to fit to the area where the tooth and crown meet for a better fit. Gold is also a healthier environment for the gum tissue.
• Disadvantage: The cosmetic aspect, unless it is being used in the back of your mouth
• Porcelain and Metal Crowns

• For a very natural appearance, porcelain fused to metal crowns are the answer. However, they have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally, a darker line will be visible at the edge of the crown, near to your gum when it recedes with age. 
• Advantage: Porcelain fused-to-metal crowns have a very natural appearance
• Disadvantage: They have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age
• Types of Porcelain
• There are two types of porcelain - felspathic and pressed ceramic porcelains. The felspathic type is the original method that has been around for 20 years. Ceramist in a dental lab bakes porcelain onto tin foil and then heats it in an oven. The Ceramist is able to create tints and opaques inside the porcelain to give the natural look we seek.
• Pressed ceramic is created from a single ingot. The single ingot is milled in one piece to create the desired shape. The stains and opaques are applied only to the surface of the porcelain to give a natural look.

How do I choose a color for the dental crowns - how white should it be?
Whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the crowns made to that color. Teeth are of course not monochromatic, so typically more than one color is used to used a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the crown look more natural.

There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:

A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray)

In the A range, there are five level of darkness. Ranges B, C, and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.

Most dentists will show you a shade chart for your to pick from. Keep in mind, with a good cosmetic dentist, this is merely a starting point. Other considerations when determining the color of crowns for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.

What is the procedure?
- Preparing (drilling) the tooth in an appropriate fashion for the type of crown chosen
- Making impressions of the prepared tooth, opposing teeth, and the occlusal (bite) relationships
- Selecting a shade for tooth-colored crowns
- Fabricating a provisional restoration that will remain in place while the crown is being constructed
- Cementing or bonding the completed crown into position. If the work to be done is extensive, there may also be several appointments needed for preliminary seating (try-in) of the crowns or castings

What do I need to do BEFORE I get the crown?
It is important for the ultimate success of the crown(s) that you understand and can perform thorough plaque removal. You should immediately begin following the oral self-care instructions that you have been given. It will make the procedure more comfortable and efficient, and the resulting restorations will look better. Final impressions cannot be taken until the gum tissue is healthy. Crown lengthening is an oral surgery treatment that involves removing excess gum tissue around the upper teeth to make them look longer. Your cooperation is appreciated and necessary.

What do I need to do AFTER I get the crown?
As is true with your natural teeth and especially with teeth that have been restored with any dental material, you should avoid chewing on excessively hard or sticky foods after the crowns have been cemented. It is especially important not to bite down on hard foods with just one tooth. The porcelain material can fracture from the metal substructure under extreme forces. Anything you chew that could break a natural tooth could break a crown!

Be sure to brush and floss daily as instructed. We also advise using a fluoride mouthrinse as part of your daily routine. Please be sure to return for your regular examinations and prophylaxis (cleaning) appointments at the time intervals we suggest.

After observing these types of procedures for many years, we note that the gingiva (gums) can recede from the crown margins and the surrounding tooth structure may become visible. This recession usually takes place over a period of several years and may require restoration replacements or a periodontal plastic surgery procedure to correct it.

We expect that you will receive many years of service from the cast restoration.

If you have any questions about crowns and bridges, call our office and ask or set up an appointment. We have 3 convenient locations around Austin.